Almost 20 years ago, physician Dr Michael Gliksman was involved in research suggesting that socioeconomic disadvantage during childhood can have lifelong health consequences.

Since then, a variety of studies have helped unpick some of the factors involved, and he says the implications for policy are now clear:

“The evidence supports the view that income support to lift all but especially children above realistic poverty levels and well-funded public education and health programs are essential.

In the Australian context this means equal health care access, school funding based on actual student need, the NDIS, and income support sufficient to ensure no child lives in poverty.”

Michael Gliksman (‏@MGliksmanMDPhD) writes:

Almost two decades ago some of us at the Harvard Medical School’s Channing Laboratory, home of the Nurses Health Study, sought to examine the link between childhood deprivation and risk of later life disease.

It was known that the relative socioeconomic status of adults is a determinant of health outcomes, including cardiovascular disease (CVD).

Could childhood socioeconomic status (SES) affect later life incidence of CVD? Can adult experience mitigate the association, if any? Until our study results were in, no-one knew.

My research group found individuals who grew up in manual (as compared to non-manual) households were at increased risk of developing CVD in adulthood, independent of the individual’s own attained SES.

So you want to make an app? What your organisation needs to know.

This was the topic of a workshop run at the Australian Health Promotion Association conference in Sydney earlier this week that was bound to draw interest, given that we seem to be living in the age of the app.

Below is a summary of workshop discussions. It is followed by some tweet-reports on other social media sessions at the conference.

First, some questions to consider

George Anderson writes:

The future is mobile – we are told. International tech giant Apple recently celebrated 50 billion app downloads since 2007. This year the tipping point was reached seeing 50% of the Australian population with a smart phone in their pocket.

So how can health-promoting organisations, which are frequently resource constrained and in risk-averse settings, build the case for new technologies and adapt a changing technological environment?

At the AHPA 2013 conference, health promotion workers were led by specialist health promotion and technology app development and consultancy Zockmelon in a workshop to help organisations understand what is involved in creating quality and evidence-informed health promotion mobile apps.

The short answer to incorporating new technology into health promotion is that ‘some things don’t change’.

New digital media is bringing “unprecedented opportunities” for evidence-informed advocacy for healthier environments for children, according to Professor Helen Roberts from University College, London.

In a keynote address to the Australian Health Promotion Association conference in Sydney today, Professor Roberts outlined some challenges and opportunities for addressing inequalities in children’s environments.

She said the Internet was proving an “amazing tool” when used by “bright and principled young people to persuade us to persuade the decision makers to do the right thing”.

She gave as an example this Avaaz petition arising out of the recent clothing factory fire in Bangladesh.

Professor Roberts urged the health promotion sector to focus on addressing “the causes of the causes” of health problems. She said: “We need to put energy and creativity into changing the behaviour of those on the supply end of health insults to children.”

As previously mentioned at Croakey, Professor Roberts also delivered one of the all-time great public health images: “Trying to change children’s health behaviours without trying to change the food and transport environment is like trying to teach them to swim in a pool full of alligators.”

She also warned against the “powerful narrative” that “some mums, especially poor ones, are bad for your health”.

This notion persisted, she said, “despite overwhelming evidence that the vast majority of mothers protect and promote the health of their children”.

The unholy alliance of the alcohol and sporting industries is doing serious harm to the community, warns Mike Daube, Professor of Health Policy at Curtin University

He asks: How can we take seriously expressions of concern about alcohol from sporting authorities such as Cricket Australia, NRL and AFL while they sell their souls and players to alcohol promotion?

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Shining a spotlight on the hypocrisy of sporting organisations that are in bed with Big Alcohol

Mike Daube writes:

Australian batsman David Warner recently attacked an English cricketer in a Birmingham bar. Cricket Australia fined him $11,500 and suspended him from playing (though not from other team activities) until the first Test in less than a month.

Fines of this nature would be challenging for most of us, but may be less of a problem for a cricketer whose contracts have led to reports of him as a “$3 million man”.

North Queensland and New South Wales Rugby League prop James Tamou was arrested for drink-driving and driving without a license. The NRL banned him for two games and reportedly fined him $20,000. It may be assumed that State of Origin stars are also well remunerated.

Warner’s punishment – following recent late night Twitter abuse for which he was fined – is barely more than a slap on the wrist.

As Wayne Smith points out in the Australian, “many critics were expecting that Warner would have been sent home”; and “his punishment does seem mild” in comparison with those handed out by Cricket Australia to other players for offences such as failing to complete their homework on time.

Tamou’s agent reportedly believes that the punishment is “pretty harsh”, and may seek to have it reduced, despite reports that he was not only drink driving and unlicensed, but had three passengers in the car.

While sporting stars such as Warner and Tamou may live in a parallel universe, where assaults and drink driving while unlicensed are likely to occur, surely we can expect more from our sporting authorities.

Herewith a selection of tweets from the Australian Health Promotion Association conference in Sydney today. (You can find a more comprehensive wrap-up at this Storify from the conference organisers, @ahpa_au.)

It seems the app workshop was very popular (and we hope to report more on this later) – a reminder of the need to broaden the capacity (and perhaps definition) of the health promotion workforce.

The most important task facing the health promotion sector is to help humanity change how we live in order to address “the converging crises of environmental degradation, climate change, resource depletion and social injustice”.

This was one of several challenges that UK expert Professor Mark Dooris issued to the Australian Health Promotion Association (AHPA) conference in Sydney today.

Professor Dooris, Reader in Health and Sustainable Development and Director of the Healthy Settings Unit at the University of Central Lancashire, dared the health promotion sector to “envision a different future and to change the way we conceptualise, organise and live our individual, community and working lives”.

He urged conference delegates to develop “an ecological perspective” and identify “what makes places liveable, vibrant and enriching” so this can be applied “to the settings of everyday life”.

Professor Dooris said:

“In looking to such a future, it will be important to focus not only on the negatives – the very real risks and ‘doom and gloom’; but also on the positives – re-engaging with the environment and the wonder of the world around us; and recognizing that within upheaval lie the seeds of hope and empowerment, and the potential for us to engage and embrace the emergence of new possibilities for enhancing the wellbeing of place, people and planet.“

He suggested that the health promotion sector needs “to step outside of our comfort zone and engage with and learn from the movements for social justice, sustainable futures and community resilience that have truly become ‘viral’, such as Transition Towns and Occupy”.

He said: “These have clearly captured people’s imagination and tapped into the zeitgeist or spirit of the age – and are where some of the most exciting change is happening. There’s huge potential for us to build partnerships to tackle some of our most taxing issues.”

The tweeters were in action at an Aboriginal and Torres Strait Islander health workshop held in Sydney today as part of the 21st national conference of the Australian Health Promotion Association (AHPA).

As previously mentioned, the Croakey Conference Reporting Service has been enlisted to help cover the conference.

Workshop participants shared photos and some of the discussions around the importance of and challenges for partnerships in advancing Indigenous health.

Corporate power is one of the major barriers to improving global health, according to Dr Margaret Chan, the Director General of the World Health Organization.

In a strong opening address last week to the 8th Global Conference on Health Promotion in Helsinki, Finland, Dr Chan also highlighted concerns about inequalities, between and within countries, which “are now greater than at any time in recent decades”.

“We increasingly live in a world of rich countries full of poor and sick people. The rise of noncommunicable diseases threatens to widen these gaps even further,” she said.

Efforts to prevent noncommunicable diseases go against the business interests of powerful economic operators, she said, and “this is one of the biggest challenges facing health promotion”.

Dr Chan said public health did not only have to contend with Big Tobacco:

“Public health must also contend with Big Food, Big Soda, and Big Alcohol. All of these industries fear regulation, and protect themselves by using the same tactics.

Research has documented these tactics well. They include front groups, lobbies, promises of self-regulation, lawsuits, and industry-funded research that confuses the evidence and keeps the public in doubt.

Tactics also include gifts, grants, and contributions to worthy causes that cast these industries as respectable corporate citizens in the eyes of politicians and the public. They include arguments that place the responsibility for harm to health on individuals, and portray government actions as interference in personal liberties and free choice.

This is formidable opposition. Market power readily translates into political power. Few governments prioritize health over big business. As we learned from experience with the tobacco industry, a powerful corporation can sell the public just about anything.

Let me remind you. Not one single country has managed to turn around its obesity epidemic in all age groups. This is not a failure of individual will-power. This is a failure of political will to take on big business.”

Dr Chan said WHO believed that the formulation of health policies must be protected from distortion by commercial or vested interests.

“When industry is involved in policy-making, rest assured that the most effective control measures will be downplayed or left out entirely,” she said. “This, too, is well documented, and dangerous.”

Health in All Policies (HiAP) was the theme of the conference, and some interesting insights emerged about what can help facilitate such approaches.

Presentations highlighted the importance of central leadership (heads of government rather than health ministers are best placed to lead HiAP), regulation, and an HiAP workforce with the ability to negotiate complexity, to facilitate social change, and to create conditions that promote favourable political decisions.

The invitation-only conference was co-organised by the World Health Organization and the Ministry of Social Affairs and Health of Finland.

Below is a wrap of some conference highlights, including an article from Professor Fran Baum reflecting upon the implications for Australia. Beneath her post are summaries of some key presentations.

The 21st national conference of the Australian Health Promotion Association (AHPA) kicks off in Sydney tomorrow.

In collaboration with conference organisers, the Croakey Conference Reporting Service will provide an overview of key sessions and discussions.

In the article below, Suzanne Gleeson, the AHPA’s National President, identifies some of the major challenges facing the field and previews some of the conference keynotes.

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It’s time to move our focus beyond “lifestyle change” – but how?

Suzanne Gleeson writes:

The experts who will be presenting at the conference are singing from the same song sheet.

The evidence is clear – we need to move beyond “lifestyle change” to building supportive environments if we are to achieve environments that are supportive of health and wellbeing – not just for some but for all.

But while we agree on what needs to happen, the how is not so clear – and this is the challenge to those of us working in health promotion.

By Kellie Bisset Tobacco control was a dominant issue this fortnight, but Closing the Gap on Indigenous health inequality, barriers to evidence-informed policy, patient safety and immunisation were also on the agenda. Here are some highlights. Towards a smoke-free zone World No Tobacco Day on 31 May saw accusations levelled at the Queensland Government for [...]